Hypoalgesic effects of three different manual therapy techniques on cervical spine and psychological interaction: A randomized clinical trial

J Bodyw Mov Ther. 2017 Oct;21(4):798-803. doi: 10.1016/j.jbmt.2016.12.005. Epub 2016 Dec 22.


Objective: The purpose of this study was to evaluate the extent to which psychological factors interact with a particular manual therapy (MT) technique to induce hypoalgesia in healthy subjects.

Methods: Seventy-five healthy volunteers (36 female, 39 males), were recruited in this double-blind, controlled and parallel study. Subjects were randomly assigned to receive: High velocity low amplitude technique (HVLA), joint mobilization, or Cervical Lateral glide mobilization (CLGM). Pressure pain threshold (PPT) over C7 unilaterally, trapezius muscle and lateral epicondyle bilaterally, were measured prior to single technique MT was applied and immediately after to applied MT. Pain catastrophizing, depression, anxiety and kinesiophobia were evaluated before treatment.

Results: The results indicate that hypoalgesia was observed in all groups after treatment in the neck and elbow region (P < 0.05), but mobilization induces more hypoalgesic effects. Catastrophizing interacted with change over time in PPT, for changes in C7 and in manipulation group.

Conclusions: All the MT techniques studied produced local and segmental hypoalgesic effects, supporting the results of previous studies studying the individual interventions. Interaction between catastrophizing and HVLA technique suggest that whether catastrophizing level is low or medium, the chance of success is high, but high levels of catastrophizing may result in poor outcome after HVLA intervention.

Trial registration: ClinicalTrials.gov Registration Number: NCT02782585.

Keywords: Manual therapy; Pressure pain threshold; Psychological interaction.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cervical Vertebrae*
  • Double-Blind Method
  • Elbow Joint / physiopathology
  • Female
  • Humans
  • Male
  • Muscle, Skeletal / physiopathology*
  • Musculoskeletal Manipulations / methods*
  • Neck Pain / therapy*
  • Pain Measurement
  • Pain Threshold
  • Physical Therapy Modalities*
  • Range of Motion, Articular
  • Superficial Back Muscles / physiopathology
  • Young Adult

Associated data

  • ClinicalTrials.gov/NCT02782585